Wednesday, December 11, 2019

Strategies to Decrease the Duration of Indwelling Urethral Catheters

Question: Identify the facts, data, or resources the author uses to support his/her argument? Answer: 1. The important information: Patient found catheter to be uncomfortable as they caused psychological distress and physiological problems such as bladder inflammation and catheter associated urinary tract infections. About 80% of the infections are associated with catheter. Long term effect of catheter associated urinary tracts infections are sepsis and even death. A study demonstrated the proper use of catheter and its maintenance (Rhodes, 2012). His study focused on the use of sterile equipment, cleaning of perianal area and proper washing of hands before insertion of catheter. placing catheter tube and bag below the bladder will prevent clogging of tube. Evidences showed that the use of multiuse lubricant instead of single tube for inserting catheter, as this will prevent CAUTI. In a study of Bernard 2012, it was evidenced that about 13000 deaths annually were associated with catheter infections. Various steps were implemented to minimize risk of CAUTI, as nurses should be aware of the procedure of maintenance of catheter and should be well trained. According to observational cohort study demonstrated that taking bath from 2% chlorhexidine gluconate, significantly reduce the risk of central line blood stream infections, surgical site infection, MRSA and VRE, which are causes of CAUTI (Carter, N.M., 2014). The article concluded that the use of indwelling catheter should be based on necessity not on convenience, as it is convenient in incontinent patients, but this is not evidence based reason. Alternatives to indwelling catheter should be provided so that risk associated with catheter infections can be minimized. Nurses should have authority to remove catheter without permission of prescribers as soon as patient meet the removal standards. Nurses should be well trained and aware with proper maintenance of catheter. References: 1. Bernard, M.S., Hunter, K.F., Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urol Nurs. Vol. 32, No. 1, pp: 29-37. 2. Carter, N. M., Reitmeier, L., Goodloe, L. R. (2014). An evidence-based approach to the prevention of catheter-associated urinary tract infections. Urologic Nursing. Vol. 34, No. 5, pp: 238-241.

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